This week, we break down a recent legal challenge to the Affordable Care Act (ACA). A court case was recently thrown into the spotlight as a result of the administration’s decision to file a brief essentially arguing that federal courts should find the ACA’s protection for people with pre-existing conditions unconstitutional. Read on to learn more.

Premium Increases

We’re excited to continue our advocacy blog series meant to help you take care when it comes to important arthritis health care and coverage issues. If you are just now tuning into this series, check out our previous blog posts on accumulator adjustment programs, pharmacist gag orders, President Trump’s drug pricing blueprint and drug rebates.

This week we are focusing on the rise in premiums for health plans sold on the Affordable Care Act exchanges. Read on to learn more about how these increases may or may not impact your health insurance options. Continue reading TAKE CARE: Advocacy Blog Series→

On Wednesday, February 28th, New Mexico joined 17 other states across the country in passing legislation to curb step therapy. Senate Bill 11, which was signed into law by New Mexico Governor Susana Martinez, reforms the process that forces patients to try drugs that insurance companies choose, making patients “fail first” before the patient gets to use the medicine that their doctor originally prescribed.

Step therapy is an insurance practice that requires patients to use a lower-cost drug before permitting more expensive drugs – regardless of what your doctor prescribed. This may occur even if you are already taking that pricier medication and doing well on it. Senate Bill 11 placed limits on this practice and helps get the right medicine to patients faster.

I have been living with rheumatoid arthritis (RA) for over a decade. As a full-time working mom and wife living with a chronic condition, the last thing I need is the added strain of fighting with my health insurer.

Unfortunately, because of a common health insurance practice known as “step therapy,” the last 10 years have been a constant and stressful battle.

On Thursday, November 2, the Centers for Medicare and Medicaid Services (CMS) announced they would reverse a policy determining how providers are paid for administering biosimilar drugs under Medicare Part B. A biosimilar is a type of medication that is “similar” to a biologic reference product, approved by the Food and Drug Administration (FDA); biosimilars offer patients the promise of more affordable treatment options available on the market to address their disease.

Over the past twenty-four months, the Arthritis Foundation and other patient organizations have expressed our collective concerns with CMS’s biosimilars reimbursement policy and encouraged them to reverse it. This policy reversal is a crucial access to care victory for the arthritis community since there are two biosimilars on the market to treat arthritis. The regulatory change will foster competition and lower the cost of expensive biologic treatments, while encouraging innovation of new therapies – ultimately creating a robust marketplace of biosimilars. Read on to learn more about this important win for patients.

On Thursday, October 12, 2017, the Administration took two actions on health care that could affect coverage for people who have health insurance through the exchanges.

President Trump signed an executive order that opens the door for the expansion of association health plans, which aren’t subject to the same level of patient protections as required by the Affordable Care Act (ACA). Second, the Administration announced the discontinuation of cost-sharing reduction payments, which are payments to health insurers that help reduce out-of-pocket costs for low income people who purchase insurance on the health exchanges.

Read on to learn more about the Administration’s actions and their potential impacts on the arthritis community.

The Senate is expected to open debate today on two bills that repeal and replace the Affordable Care Act. Tell your senator to vote no and work to write a health bill that serves patients!

Not getting health insurance because you have a pre-existing condition.

Thousands upon thousands of dollars in out-of-pocket costs every year with no end in sight.

Fear of reaching your maximum lifetime benefit because you take expensive drugs or had multiple surgeries and hospital stays.

This is what life looked like for many people before the Affordable Care Act (ACA) was passed into law in 2010. While the ACA is far from perfect, it offers critical protections like caps on annual out-of-pocket spending, a ban on lifetime coverage limits, a prohibition on pre-existing conditions exclusions and minimum essential health benefits like prescription drugs and hospitalizations.

On June 2, Colorado Governor John Hickenlooper signed Senate Bill 203 (SB 203) into law! This important bill stops insurance plans from requiring patients to go through step therapy for their medication if they previously went through step therapy protocols with their current or former insurer.